Joint Replacement Surgery

Understanding Joint Replacement Surgery

Hip and knee joint replacement surgeries are among the most common and successful surgical procedures in the United States. More than 190,000 total hip replacements and more than 500,000 total knee replacements are done each year in the US.

More than 1,000 such procedures are done each year at the Wellstar Center for Joint Replacement, which holds Joint Commission Disease Specific Care Certification in total hip and total knee replacement. The procedures are most typically performed to ease the pain caused by osteoarthritis.

Risks of Joint Replacement Surgery

Joint replacement is major surgery. It is important that you are aware of potential risks and complications. These include problems from anesthesia, infection, bleeding from your incision, blood clots, damage to nerves or blood vessels, dislocation with hip replacement, and very rarely, death. Although these complications are rare, they are possible. Every precaution is taken by your healthcare team to avoid these complications. Over time, an artificial joint may become loose or wear out, and may require further surgery and repair.

What results can you expect from a joint replacement?

Generally, joint replacement is successful. Pain is relieved, deformity is corrected and patients resume former activities and enjoy an active lifestyle. Long-term success rates vary from 15 to 25 years, depending on age, weight and activity level.

Total Hip Replacement Surgery

Total hip replacement—also known as hip arthroplasty—is a course of treatment for those with chronic hip pain caused by arthritis or injury. It is considered when the joint pain prevents your daily activities, such as walking, climbing stairs or getting up from a chair. If hip pain keeps you awake at night, you may also be a candidate for hip replacement surgery.

Total hip arthroplasty is performed under general or regional anesthesia. The surgical procedure includes removing the diseased hip joint and replacing it with an artificial joint, which consists of a stem, made of metal, a ball component, made of metal or ceramic, and a socket, made of plastic or metal.

Standard Hip Replacement

Standard Hip replacement surgery replaces your arthritic hip joint with an artificial joint composed of a ball component and a socket component. A ball, which can be made of metal or ceramic, is attached to a stem that fits into your thighbone. This component can be cemented or non-cemented depending on your age and the condition of your bone. A plastic liner with an outer metal shell is secured into your pelvis. Your orthopedic surgeon will choose the type of prosthesis that best meets your individual need. Once in place, the artificial ball and socket function essentially in the same manner as your natural hip.

There are two approaches to total hip replacement surgery: the standard posterior approach and the anterior approach. The incision in hip replacement surgery varies in size and location depending on the approach used. Your surgeon will choose the approach that is appropriate for you.

Hip Resurfacing

Hip resurfacing is intended for active adults who are generally under 60 years of age with strong bone around the hip joint. Active patients who suffer from hip pain due to arthritis, dysplasia or avascular necrosis may benefit from the bone-conserving approach of the hip resurfacing. There are certain causes of hip arthritis that result in extreme deformity of either the head of the femur or the acetabulum. These cases are usually not candidates for hip resurfacing. The hip resurfacing implant is made up of a metal mushroom-like cap, which is inserted over the top of the resurfaced femoral head, and a metal cup that is pressed into the socket. The bone then grows into the socket adding increased stability.

With all hip replacements or resurfacings, you will be instructed on the hip precautions that pertain to your approach. There are some risks associated with a hip replacement. The risks, while not common, include:

• Blood clots. Your WellStar physician may give you blood-thinning medication after the surgery to reduce the risk of blood clots.
• Infection
• Altered leg length. The new hip may make one leg shorter or longer than the other. Some patients may wear a shoe lift after surgery.

Total Knee Replacement Surgery

Total Knee Replacement—also known as knee arthroplasty—is done to ease pain and restore function in diseased knee joints damaged by osteoarthritis, rheumatoid arthritis or arthritis from injury.

Total knee replacement may be an option if severe knee pain limits everyday activities such as walking and climbing stairs, and if pain persists even when resting and fails to respond to non-operative treatment, including oral medications, injections and physical therapy.

Total knee replacement surgery, done under regional anesthesia, takes about one hour. The damaged cartilage and bone are removed, and the surgeon installs three new parts:

• The femoral and tibial components made of metal
• The tibial insert made of plastic
• The patellar component made of plastic

There are some risks associated with total knee replacement. The risks are rare; fewer than 2% of people undergoing knee replacement surgery experience serious complications. Those complications may include:

• Blood clots. Your Wellstar physician may give you blood-thinning medication after the surgery to reduce the risk of blood clots.
• Infection
• Nerve damage